I challenge both Lisas to make this weight loss effort different by focusing first on self-observation. I want them to pay as much attention to themselves as they do to their children—especially the way they react to all forms of physical and emotional nurturing, from food to kisses.

I tell Lisa Romeo that we will have daily contact—but instead of me checking on her, she has to e-mail me. I'm not the authority on her life: She is. So I ask her to send daily reports of her own eating, feelings and thoughts. That pushes her into the role of self-observer, while making her the leader in our interactions.

Lisa Kogan's job is quite different. I want her to ask less of herself, and view me as a soft place to land, not someone who wants more from her. Though she's wary, she eventually allows me to cajole her into observing herself as she would a friend. For example, to help Lisa K. forgive herself for rebound weight gain, I describe a 1940s diet in which healthy young men volunteered to participate. Many of the subjects became binge eaters. Their self-esteem plummeted, they became hostile and angry, and a couple of them began to steal things. When the study ended, the bingeing got worse, not better. That's what starvation—even a voluntary diet—does to the human psyche. When Lisa K. finally agrees that she deserves the same forgiveness, her energy changes. It's like ice melting.

After both Lisas promise to observe themselves in general terms, I teach them a specific self-observation technique, one I've humbly named the Most Important Weight Management Skill in the History of the Universe.

As a reminder, always consult your doctor for medical advice and treatment before starting any program.


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